Rosacea Treatment

One of the first treatments for rosacea is to eliminate from your diet or lifestyle whatever triggers the flare-ups, such as alcohol, stress, spicy foods, and sun exposure. It may be helpful to keep a diary of what you eat, drink, and have done during the day and to note the days on which the rosacea appears. Then you can take the record to your next doctor's appointment and discuss lifestyle changes that can help you control the disease.
Antibiotic creams and sometimes oral antibiotics are used to treat the pimples that develop. Antibiotic creams, however, may cause burning and stinging for some people, who may find oral antibiotics, such as tetracycline, a better option. Women who are pregnant should not use some antibiotic creams or tetracycline.
If antibiotics don't control your rosacea, other medications, such as isotretinoin (Accutane) or tretinoin cream (Retin-A), may be used, unless you are pregnant. Laser therapy may be helpful in treating the red lines (telangiectasia) of rosacea, but it is usually used only in advanced cases. Dermabrasion, cryosurgery, or laser surgery may be used to treat advanced cases of rhinophyma.
About half of the people who have rosacea also have eye irritation. Oral antibiotics and topical corticosteroids may be used to treat eye problems.
When outdoors, always wear sunscreen to control flare-ups. Also avoid heavy cosmetics and irritating skin care products.

Celebrity Derm Claims Tap Water Damages Skin

Dr. Dennis Gross, celebrity dermatologist, says tap water contains heavy metals which breakdown collagen and lead to wrinkles. Heavy metals such as iron, copper, magnesium, lead and zinc are free radicals.
These elements build up on the skin's surface and cause dermatologic problems such as those Gross first noticed in his practice when clientele consisting of magazine editors, socialites and designers returned from the fashion shows in Milan with terrible skin.
"Heavy metals on the skin can lead to skin conditions such as acne, rosacea, irritation, inflammation and aging," say Dr. Dennis Gross, author of Your Future Face (Viking 2005). He concluded there are great variations in the content of heavy metals, calcium, and sulfates from one city to the next.
"While the water is clearly drinkable, if you are unlucky enough to be exposed to bad water on a regular basis your skin can suffer the same kind of damage, although to a lesser degree, as sitting in the sun with suboptimal protection," says Dr. Gross, associate clinical professor at New York University Medical Center.

Ocular Rosacea Can Be Worse In Winter

If you're bothered by irritation, burning or a gritty feeling and redness in your eyes, you're not alone. Winter can bring a host of special challenges for rosacea patients, and the effects of dry eye head the list for many.
"Millions of people suffer from dry eye, and it accounts for 17 percent of all ophthalmologic visits," said Dr. Marian Macsai, chairman of ophthalmology at Northwestern University. "We definitely see more of it during the winter months because of the dryness of the environment, and it often accompanies rosacea."
Dr. Macsai explained that dry eye is either an inability to produce natural tears, or occurs because the oily (lipid) layer in the tear film is unhealthy or incomplete. A dry and windy environment can also cause more rapid evaporation of the aqueous layer of tears. In patients with eye (ocular) manifestations of rosacea, this condition is frequently made worse by blockage of the meibomian glands at the base of the eyelashes, which produce the lipids that hold the moisture on the surface of the eye.
In a recent National Rosacea Society survey of 1,780 rosacea patients reporting ocular symptoms, 95 percent said their eyes had felt dry, gritty or irritated, yet only 28 percent said they had been diagnosed with ocular rosacea.
"If the symptoms of ocular rosacea persist, it's a good idea to make an appointment with an ophthalmologist," said Dr. Macsai. Left untreated, patients with severe ocular rosacea could endure potentially serious consequences, such as scarring within the eyelid or corneal damage that could lead to decreased vision.
For mild symptoms, Dr. Macsai advises patients to use a humidifier or other means to raise the humidity at home or in work environments. She also noted that artificial tears are available at drugstores to moisturize the surface of the eye.
For her rosacea patients with dry eye problems, Dr. Macsai also emphasizes good eyelash hygiene to minimize blockage of the meibomian glands. She suggests a daily eyelash shampooing that can be performed at the end of a morning shower. Place a drop of baby shampoo on a wet washcloth and carefully rub it onto a closed eye to create a slight lather. Rub the washcloth gently back and forth in a horizontal motion over the upper and lower eyelashes. After shampooing the eyelashes on one eye, shampoo the eyelashes on the other eye.
Then, keeping the eyes closed, put your face under the shower water and rinse off all of the soap until the eyelashes feel squeaky-clean. Gently towel dry. This procedure may also be used in the bath or in front of the sink.
"Your doctor may also prescribe an ointment to rub into your lashes twice a day," Dr. Macsai said. "If any eye symptoms persist or worsen at any time of the year, make an appointment with an ophthalmologist."

NRS Announces New Research Grants

The National Rosacea Society (NRS) announced that five new studies have been awarded funding as part of its research grants program to advance scientific knowledge of the potential causes and other key aspects of this chronic and potentially devastating disorder that affects an estimated 14 million Americans.
"We are very pleased that a growing number of high-quality research proposals are now being received," said Dr. Jonathan Wilkin, chairman of the society's medical advisory board, which reviews each grant application and selects for funding those believed most likely to yield important results. "As this program continues to expand, we are optimistic that it will lead to significant advances in the management of this poorly understood disorder and its potential prevention or cure."
Dr. Martin Steinhoff, department of dermatology, University of Muenster, Germany, and colleagues were awarded a $25,000 grant. They hypothesize that a protein known as endothelin-converting enzyme-1 (ECE-1) may regulate vascular function and nerve-caused inflammation in the skin, and thus be involved in the pathophysiology of rosacea. The study aims to define the expression and distribution of the four ECE-1 isoforms in both normal and rosacea tissue, which may lead to new strategies to treat rosacea.
Dr. Richard Granstein, chairman of dermatology at Cornell University, and colleagues received a research grant of $25,000. In past research, Dr. Granstein and colleagues found that substances that activate endothelial cells through the P2 cell receptors cause the release of factors that recruit and promote inflammation. In the new proposal, they will study which P2 receptors are affected, and whether inhibiting these substances in vitro may facilitate the discovery of new treatments for rosacea.
Dr. Richard Gallo, chief of the division of dermatology at the University of California-San Diego, and Dr. Kenshi Yamasaki of the Veterans Medical Research Foundation also received a $25,000 grant. In earlier studies, they discovered that individuals with rosacea have too much of a type of natural antibiotic called cathelicidins, and plan to use animal models and artificial cell culture techniques to further examine the function and activity of cathelicidin-processing enzymes in rosacea skin. If successful, the experiments may show that abnormal regulation of cathelicidin production leads to rosacea, leading to completely new therapeutic approaches.
Dr. Payam Tristani-Firouzi, assistant professor, and Dr. Nancy Samolitis, visiting professor, department of dermatology, University of Utah, were awarded $23,600 to examine the effect of pulse dye laser (PDL) and intense pulsed light (IPL) treatment of rosacea to determine whether, in addition to reducing the amount of blood vessels, these procedures produce structural and biologic changes in the skin. The Rosacea Research Foundation donated $16,065 to the NRS toward the funding of this study.
Dr. Tristani-Firouzi and Dr. Samolitis will visually and microscopically assess the primary features of rosacea before and after treatment with PDL and IPL, including redness, visible blood vessels, and bumps and pimples. In addition, biopsy samples before and after treatment will be tested for factors that play a potential role in rosacea, including inflammatory cells, vascular endothelial growth factor (VEGF) and others.
They will also assess the size of the oil glands and the presence of Demodex mites, normal inhabitants of human skin that have been observed in greater numbers in rosacea patients. The study will include 10 patients with subtype 1 (erythematotelangiectatic) and subtype 2 (papulopustular) rosacea, each receiving treatment on one side of the face, with the other side serving as a control.
Dr. Yaxian Zhen and Dr. Albert Kligman, department of dermatology, University of Pennsylvania, will receive $25,000 to develop objective, quantitative assessments of rosacea using a variety of equipment. They note that these noninvasive methods would provide a means to measure the presence and severity of rosacea's known symptoms, perhaps identify others, and gauge their presence and severity after treatment.
The instrumentation includes scanning laser Doppler imaging, optical coherence tomography, confocal microscopy, specialized digital photography, colorimetry by chromometer and surface (nonsurgical) biopsy. Skin hydration would be measured via an electrical conductance device and a capacitance measuring device, and the skin's topography studied by a fringe projection device.
In an earlier study, Dr. Zhen and colleagues showed that rosacea shares many common features with acne, including increased sebum production and density of Demodex mites, as well as the presence of the bacterium Propionibacterium acnes.
Researchers interested in applying for grants can obtain forms and instructions by contacting the National Rosacea Society, 800 South Northwest Highway, Suite 200, Barrington, Illinois 60010, telephone 1-888-662-5874, e-mail rosaceas@aol.com. The deadline for submitting proposals for research grants in 2006 is September 15. More information is available online at www.rosacea.org/grants/.
Because the etiology of rosacea is unknown, a high priority in awarding grants is given to studies relating to its pathogenesis, progression, mechanism of action, cell biology and potential genetic factors. Proposals relating to epidemiology, predisposition, quality of life and relationships with environmental and lifestyle factors may also be considered.
Rosacea is a chronic disorder primarily of the facial skin, characterized by flare-ups and remissions. According to the NRS standard classification system for rosacea, developed by a consensus committee and review panel of 17 medical experts worldwide, its primary features include flushing, persistent erythema, papules and pustules, and telangiectasia, while secondary features may include ocular manifestations, burning and stinging, plaques, dry appearance, edema, locations beyond the face and phymatous changes. In most cases, some rather than all of these signs and symptoms appear in any given patient.
The National Rosacea Society is a nonprofit organization dedicated to improving the lives of people with rosacea by raising awareness, providing public health information and supporting research on this common but biologically poorly understood disorder.

More Rosacea Facts

Rosacea is a chronic and often progressive skin disease that causes redness and swelling on the face.
Rosacea is a chronic and often progressive skin disease that causes redness and swelling on the face. Most people affected by the condition are fair-skinned between the ages of 30 and 50. Rosacea often runs in families, with women being affected more than men. Men, however, often get more severe forms of rosacea. For an estimated 16 million North Americans, rosacea most often goes untreated due to lack of awareness about this common skin disorder. "Because it is so noticeable on a person’s face, rosacea can be socially and emotionally distressing," said Dr. Pelle, M.D., clinical associate professor of dermatology, University of California. "While the cause of rosacea is unknown, the good news is that this condition can be controlled if people know and look for the symptoms, as well as follow a supervised treatment plan.” Often incorrectly referred to as "adult acne," rosacea may begin as a tendency to flush or blush easily. Rosacea progresses to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin and nose. As rosacea progresses, tiny blood vessels and pimples without blackheads begin to appear on and around the reddened area. In more advanced cases, a condition called rhinophyma may develop. Less common in women, rhinophyma is characterized by a bulbous, enlarged red nose and puffy cheeks. Thick bumps also can develop on the lower half of the nose and cheeks. "There is no cure for rosacea and it can become significantly worse without treatment," advised Dr. Pelle. "The key is to identify the condition early. When the skin doesn’t return to its normal color and when other symptoms such as tiny blood vessels and pimples become visible, it’s time to see a dermatologist for professional treatment."The best prevention for rosacea may be to avoid "triggers," or things that make the face red or flushed. Triggers can vary from person to person, however common ones include hot or spicy foods, alcohol, sun exposure, physical exertion, extremes of emotion, rubbing the face and using irritating topical products and cosmetics. Menopause also has been known to be a trigger for rosacea. In addition, it is important for rosacea patients to care for their skin by using gentle facial products that do not cause excessive dryness or contain additives such as glycolic acid or alcohol that may further irritate the skin.
Rosacea flare-ups also can be minimized by protecting skin from the sun. Dermatologists strongly recommend the daily use of a broad-spectrum (UVA and UVB protective) sunscreen with a Sun Protection Factor (SPF) of 15 or higher, seeking shade when possible and wearing protective clothing such as a long-sleeved shirt and wide-brimmed hat.
Standard medical therapies for rosacea include topical and oral anti-inflammatory and antibiotic medications. Treatment regimens for rosacea are specific to each patient depending upon the severity of his or her condition. The three main topical rosacea medications approved by the Food and Drug Administration (FDA) for rosacea include topical metronidazole, the newer topical azelaic acid, and sodium sulfacetamide and sulfur formulations that include cleansers and lotions for the skin. If rosacea symptoms persist, dermatologists may prescribe oral medications in combination with topical therapies to bring rosacea symptoms under control. Dr. Pelle advises her rosacea patients to apply an emollient cream in combination with a topical retinoid cream before bedtime to achieve the best outcome.

The Benefits Of Sulfur In Rosacea Treatment

Sulfur has been found to be an effective treatment option for rosacea. Although too much of a good thing can also be bad. Higher concentrations of sulfur can lead to skin irritation in those with sensitive skin. Many prescription based sulfur treatments contain sulfur concentrations of 2 to 15 percent.

Lower concentrations of sulfur have been found to be equally if not more effective and much less irritating. One such product wiht a lower but effective concentratuion of sulfur is Rosacea- Ltd.

In a double-blind clinical study of 40 rosacea patients, these physicians found that rosacea-related papules and pustules responded much better to topical 10 percent sulfur than to oral antibiotics. More specifically, they found that with four weeks of topical sulfur treatment, the average number of papules and pustules dropped significantly (from 213 pimples before treatment to 17 pimples after treatment), that this clearing was much better than that attained by treatment with oral tetracycline. In a separate series of clinical studies, similar results were found by Dr. Strauss and colleagues (Dr. Strauss).